Individual
MRS. AMANDA RAE MOTL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CD, CDE
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-2247
Mailing address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-2247
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1944-29
WI
Other
Enumeration date
09/24/2015
Last updated
09/24/2015
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